The apparatus of the present invention generally relates to a structure for use in maintaining a patient in an appropriate prone position during back surgery and in particular to such a structure which allows the surgeon to selectively position the patient with respect to the surgeon so as to provide the surgeon with the most convenient access to the site of surgery and manipulation of the patient during surgery, especially for rotation of the patient.
Positioning of the patient is an important consideration in back surgery. In general a patient undergoing back surgery must be positioned in a prone position to provide the surgeon adequate access to the surgical site. Initially, patients were simply placed on their stomachs on the operating table or on a mattress or board positioned between the operating table and the patient. Although this technique provided access to the back, it also suffered drawbacks.
Back surgery is often accompanied by substantial blood loss. It has been found that placing a patient on their stomach on a table or mattress increases the intra-abdominal pressure which tends to increase the blood loss. Blood loss may be reduced by supporting the patient in a prone position with the abdomen pendulous and free. With this principal in mind, structures were devised which would support a patient in such a prone position.
Typically, a patient is supported in a prone position by two sets of opposed pads arranged in V-shaped pairs and connected by a framework. One pair of opposed pads supports the lateral aspects of the upper thoracic cage and the other pair supports the antero-lateral aspects of the pelvic girdle thereby allowing the abdomen to hang pendulous and free.
Although such support structures help reduce blood loss, they limit the ability of the surgeon to adjust the position of the patient during surgery. During surgery, it is desirable to be able to raise and lower the patient, to raise one end of the patient relative to the other, and to tilt the patient's back towards or away from the surgeon along an axis running generally through the spine, that is to rotate the patient from side to side. The existing support structures which support a patient in a prone position with the abdomen pendulous and free are not adapted to allow such manipulation by the surgeon.
The existing support structures also present serious shortcomings with regards to the act of placing a patient on the support structure. Generally, the patient is brought into the operating room in a supine position on a gurney. The surgical team manually lifts the patient off the gurney and then turns the patient over and onto the support pads of the support structure. This procedure is difficult and potentially harmful to the patient, especially if the patient has a broken back.
Existing support structures also provide limited access to the surgical site for other surgical equipment, such as X-ray equipment. Many previous back surgery support structures are simply positioned on a standard operating table and do not provide access beneath the support structure for a C-arm type X-ray apparatus, that is, the support structures are in the way of the X-rays generated by the X-ray apparatus.